Cardiac Screening
October 31, 2014
Sudden death among 12 to 25-year-olds is “a low event rate occurrence.”
“There is insufficient information to support the view that ECGs in asymptomatic young people for cardiac disease is appropriate or possible on a national basis for the United States, in competitive athletics or in the general population.”
“At present, there is no mechanism available in the United States to effectively create national programs of such magnitude, whether limited to athletics or including the wider population of all young people.”
“There is insufficient evidence that particularly large-scale/mass screening initiatives are feasible or cost effective within the current US healthcare infrastructure . . .”
“The ECG . . . cannot be regarded as an ideal or effective test when applied to large healthy populations.”
“An additional, but unresolved, ethical issue concerns whether students who voluntarily engage in competitive athletic programs should have advantage of cardiovascular screening, while others who choose not to be involved in such activities (but may be at the same or similar risk) are in effect excluded from the same opportunity.”
The AHA’s Sept. 14 AHA writing group “does not believe the available data support significant public health benefit from using the 12-lead ECG as a universal screening tool. The writing group, however, does endorse the widespread dissemination of automated external defibrillators which are effective in saving young lives on the athletic field and elsewhere.”
Living With Change
December 1, 2017
One of the odd and irksome scenes I observe occurs when a relative newcomer to an enterprise lectures more seasoned veterans about change. About how change is all around us, and inevitable. About how we must embrace it and keep pace with it.
All that is true, of course; and no one knows more about that than the veteran being subjected to the newcomer’s condescension.
No one “gets it” better than those who have lived and worked through it. Short-timers can’t claim superiority on a subject they’ve only read or heard about.
Who has the deeper appreciation of change in our enterprise? The person who started working before the Internet, or after? Before social media, or after?
Who has keener knowledge of change in youth sports? The person in this work before, or after, the Amateur Athletic Union changed its focus from international competition and the Olympics to youth sports?
Who sees change more profoundly? The one who launched a career before the advent of commercially-driven sports specialization, or the one who has only seen the youth sports landscape as it exists today?
Who can better evaluate the shifting sands: newcomers or the ones who labored before colleges televised on any other day but Saturday and the pros televised on any other day but Sunday (and Thanksgiving)?
Where newcomers see things as they are, veterans can see things that have changed. They can be more aware of change, and more appreciative of its pros and cons. They didn’t merely inherit change, they lived it.